Introduction:
The prevalence of obesity and metabolic consequences such as nonalcoholic fatty liver diseases (NAFLD) have considerably increased over the last several years, with NAFLD being the most common cause of chronic liver disease in the Western world. Lifestyle modifications, especially weight loss, effectively reduces liver injury in patients with NAFLD. Bariatric surgery is an intervention that leads to significant and long-term weight loss. Therefore, bariatric surgery is a possible treatment option for patients with NAFLD. The aim of this study is to evaluate the association of patients who had undergone bariatric surgery on the outcomes of patients who were hospitalized with NAFLD.

Methods:
This is a retrospective study of adult patients hospitalized with NAFLD and who underwent bariatric surgery in the United States in the year 2020. Analysis was conducted using the National Inpatient Sample (NIS) database of the Healthcare Utilization Project (HCUP). Baseline characteristics were identified for patients who had NAFLD (table 1), and the study population was divided into two groups according to whether they had bariatric surgery or not (table 2). Clinical outcomes including in-hospital mortality, length of stay, and total hospital charges were compared between the two groups.

Results:
In a comprehensive analysis encompassing 82,414 admitted patients who had previously undergone bariatric surgery, the study revealed that among this cohort, 1,295 individuals were identified as having NAFLD. The comparison of outcomes between NAFLD patients with and without bariatric surgery highlighted significant differences. The bariatric surgery group demonstrated lower inpatient mortality (<1% vs. 4.2%, p = 0.007). Patients in the bariatric surgery group had a shorter length of stay (2.7 +/- 0.5 days vs. 6.0 +/- 0.1 days) and a slightly lower hospitalization cost ($74,516 +/- $9,308 vs. $77,430 +/- $3,900).

Conclusion:
Our study comparing bariatric surgery as an intervention for patients with NAFLD suggests that bariatric surgery is associated with improved clinical outcomes, including lower mortality rates, shorter hospital stays, and potentially more cost-effective healthcare resource utilization in patients admitted with NAFLD.

Ali Nawras

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